Bobak Bakhshoudeh

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

057492-1 Issued in NY

Practice address

25 Tudor City PL
Apt 2122
New York, NY 10017-6819

Phone

(631) 880-2208

NPI assigned

May 1, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561766400000",
    "number": "1053756205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 E 38TH ST APT 6D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169821",
            "telephone_number": "631-880-2208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 TUDOR CITY PL",
            "address_2": "APT 2122",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176819",
            "telephone_number": "631-880-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKHSHOUDEH",
        "first_name": "BOBAK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-01",
        "last_updated": "2019-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "057492-1",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "057492-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel F Bakhoum, M.D., PH.D.
• Ashima Thakur Bakhru, MD.
• Rima Bakhru, O.D
• Pegah Bakhshi
• Tatyana Bakhshiyeva, ANP-BC
• Roshan S Bakhtiar-Cummins, DMD
• Zahra Bakhtiar, MD
• Nojan Bakhtiari, D.D.S.
• Bakir Mohammed Altai
• Azza Bakkar, MD

• Endodontics in New York, NY
• Providers in New York, NY by specialty
• Endodontics in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.